Training Outcomes Research Articles

Impact of haptic simulator in prosthodontics training during preclinic dental education: a systematic review protocol

Background Prosthodontics significantly impacts oral health-related quality of life, especially oral comfort, functions, aesthetics, and overall well-being. This discipline is grounded in a solid academic and evidence-based understanding of fundamental principles for managing dental diseases and aims to restore the health of teeth and supporting tissues and compensate missing ones. Dental education is evolving quickly with the rise of digital dentistry, especially in prosthodontics. Integrating augmented reality simulations and haptic feedback has significantly advanced this transformation. This systematic review protocol intends to determine the effectiveness of haptic simulators in prosthodontics training during preclinical dental education. Methods An exhaustive search strategy will be employed, exploring PubMed, Scopus, EBSCO, Web of Science and Cochrane Central to select relevant studies, thereby enhancing the robustness of the review findings. Boolean operators (AND,OR) were utilized to assemble MeSH terms and relevant keywords. Titles and abstracts screening to identify studies that satisfy the eligibility criteria was followed by the quality and risk of bias assessment for the selected studies, via the Cochrane Collaboration’s tool and the Newcastle-Ottawa Scale (NOS). Data will be collected via standard form. Reviewers disagreement will be solved throughout debate, or by referring to a third opinion. This protocol will adhere the recommendations appointed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Discussion The outcomes of this systematic review are highly significant for dental education exploring the importance of enhancing haptic simulation during preclinic prosthetic training. Recognizing the strengths and weaknesses of virtual reality (VR) in relation to traditional preclinical training methods is crucial for developing effective educational strategies. This understanding can lead to enhanced training outcomes and increased student satisfaction, which in turn contributes to improved quality of clinical prosthetic services. Systematic review registration PROSPERO: CRD42024603681 (Registered on 30/10/2024).

Evaluation of medical ethics education using the CIPP model: a study on the perspectives of medical students

Many medical schools are adopting varied teaching strategies to enhance students' understanding of the humanitarian aspects of their specialties. This study evaluated medical ethics education at Kerman University of Medical Sciences (Iran) from the students’ perspectives using the CIPP modelA cross-sectional study involving 136 clerkship medical students used convenience sampling and a validated, researcher-made questionnaire based on the CIPP model. The questionnaire, divided into context, input, process, and product sections, assessed the achievement of the program's goals, requirements, implementation, and outcomes of the medical ethics training program.The results revealed that the product domain scored the highest (79.17±21.82), while the input domain scored the lowest (54.30±29.00). The medical ethics program successfully communicated ethical concepts and enhanced students' understanding, excelling in the product domain. However, it requires improvements in the context, input, and process areas, such as aligning materials with cultural norms, and boosting students.It is hypothesized that the medical ethics program at Kerman University of Medical Sciences is robust and aligns well with the CIPP model standards. While the program excels in educational outcomes, there is room for improvement in the context, input, and process dimensions. This study offers pivotal insights for advancing and refining future medical ethics programs.

Finding Solutions to Scaling Parenting Programs That Work: a Systems-Contextual Approach.

Prevention science has now encompassed decades of research exploring risk and protective factors and effective programs for the prevention and treatment of childhood behavioral, emotional, and developmental concerns. This paper shares our experience over the last 40years as program developers and researchers in responding to contemporary needs and finding solutions to barriers preventing access to evidence-based parenting support. We propose a systems-contextual approach to designing and implementing programs that meet families' needs and preferences and promote self-regulatory capacity across the lifespan. Key areas discussed are innovations to improve the reach of evidence-based parenting support (e.g., online program delivery, cultural adaptation, and tailored programs to engage vulnerable children and families), innovations to improve professional training outcomes (e.g., competency-based training, peer supervision and support, implementation support, and workforce development), and innovations to meet future needs (e.g., embracing new technology, standing by science, and considering global issues). It is incumbent on program developers, researchers, and clinicians to continue to evolve our practices and service systems in response to new evidence, societal changes, and technical advances to remain relevant and impactful in shifting prevalence rates of conduct problems and promoting child, family, and community well-being.

Paired Sample T-Test on English-Indonesian Translation by EFL Students Before and After Knowing Translation Process

Translation studies on translation quality should not be limited to the level of the product-oriented; it can also be associated with the translator, who simultaneously represents an outcome of the translation training. This study connected applied translation studies, particularly translation training, with descriptive translation studies oriented toward the product. The research aimed to identify the differences in students' abilities in translating English-Indonesian texts before and after they acquire knowledge about the translation process applied with a task-based teaching method adapted from Silva and Fernandes (2016). The subjects in this study were 19 students taking a translation course. Data collection involved pretest and post-test scores on English-Indonesian text by the EFL students. The pretest scores were taken from (Suyasa et al., 2023). The post-test scores were taken by providing translation tests from English into Indonesian after giving the translation process model by Bell (1991). The translation results were then scored based on Larson's theory (1989) with the assistance of two translation experts based on the rubrics provided. The scores of the students’ translations, which served as the data in this study, were then analysed quantitatively. The translation scores before and after implementing the task-based teaching method were analysed using the t-test statistical method to find out the significance level of knowing the translation process model in improving EFL student translation competence. The t-test analysis results showed that the sig. (2-tailed) value was 0.00. This value was smaller than the critical value (0.05). Therefore, it can be concluded that translation process knowledge given using the task-based teaching method is an effective approach for improving students' knowledge of the translation process model, which in turn boosts their translation competence.

Speech-language pathology students’ satisfaction level towards e-learning instruction methods of clinical practicum during the COVID-19 pandemic

ABSTRACT Satisfaction of education programmes is fundamental to accomplishing a professional identity of the graduates especially in programmes where clinical practicum forms a core element in the education process. This study aimed to detect the overall SLP students’ level of satisfaction with online instruction of clinical practicum during the COVID-19 pandemic. A questionnaire was administered for a convenience sample of two cohorts of students (n = 186). The number of participants who responded to the questionnaire, n = 149. The questionnaire was based on a construct of 30 questions, developed on a basis to reflect the components of key points such as student-patient-supervisor interaction, assessment, and treatment plans, the success of treatment, infection control measures, student skills, and training outcomes, student evaluation, use of instruments and tools, as well as report writing. Students rated their online instruction as very low. Only 30.7% agreed or strongly agreed that they were satisfied and fulfiled the expected training outcomes. ‘Self-reliance in searching for information from different resources’ was the most cited motivation for satisfaction. ‘Deprivation from exposure to instrumentation’ was the most cited motivation for dissatisfaction. The findings support the literature in the area of student satisfaction with e-learning methods of instruction in speech pathology programmes and reveal several implications regarding the satisfaction/dissatisfaction balance.

A Typology for Rural Residency Training

Abstract Until rural track program definitions were recently established in regulation and accreditation,1 there was no widely accepted classification system for rural graduate medical education (GME), making it difficult to conduct educational research, compare published results, or navigate the maze of options available to residency applicants. This typology for rural residency training, refined in use by rural medical educators, student applicants, and researchers2,3 over the past 2 decades, addresses varying degrees of required rurally located training, rural focus, and rural graduate placement outcomes. Acknowledging the range and differences across rural and frontier communities, this typology considers to be rural a geographic location that is rural by any 2 of the more than 75 federal definitions that exist (e.g., Core-Based Statistical Areas, Rural-Urban Commuting Area codes). For 8 common federal definitions, see RHIhub’s “Am I Rural?” Tool at https://www.ruralhealthinfo.org/am-i-rural.

Benefits of promoting scholarship among program directors: promoting scholarship among directors is a win-win-win for institutions, trainees, and directors.

When the National Institutes of Health (NIH) budget doubled in the late 1990s, it led to a rise in the number of PhD-trained scientists and to increased NIH-funded programs to diversify the biomedical workforce. This trend has seen more PhD scientists take on leadership roles as program directors in academia. These program directors are often highly skilled in research design and data analysis, and they bring a scholarly approach to their administrative duties. Despite organizational challenges, promoting scholarship among program directors offers numerous benefits, including enhanced institutional reputation and better training outcomes. Herein we use examples from peer reviewed literature to illustrate how publications by program directors have influenced national policies and practices in biomedical training. Encouraging more academic institutions to support program director scholarship can yield significant returns for institutions, trainees, and the directors themselves.

Val66Met Polymorphism of the BDNF Gene and Work Intellectual Complexity: Associations with Speed Characteristics of Cognitive Activity in Aging

The high heterogeneity of cognitive aging is explained by the influence of both genetic and environmental factors. It has been shown that increasing cognitive reserve prevents the development of aging-related cognitive impairment. Education and level of professional activity are considered external factors in the formation of cognitive reserve. BDNF (brain-derived neurotrophic factor) is a neurotrophic factor involved in the processes of plasticity of the mature brain. A polymorphism (Val66Met) of the BDNF gene is associated with differential expression of BDNF, suggesting its potential role in the on cognitive training outcomes. The associations between Val66Met polymorphism and the effectiveness of mental training caused by and work intellectual complexity throughout adult life (in our study, a comparison of scientists - SA and people not associated with professional scientific activities — NSA remain unstudied. The objective of the study was to assess the modulating effect of these factors in relation to aging-related changes in the processes of attention and figurative creativity in models that allow us to consider both the efficiency and speed aspects of activity. The study involved 257 healthy young and 162 elderly Caucasians belonging to the groups of SA and NSA. It has been shown that the Val66Met polymorphism of the BDNF gene is associated with the influence of the level of professional activity on the efficiency of cognitive functions only in elderly subjects. At a higher intensity of intellectual activity (SA), Val/Val, but not Val/Met carriers, showed a reduction in the average reaction time in the Attention network test and an increase in fluency when testing figurative creativity compared to similar indicators of elderly subjects in the NSA group. The results obtained indicate greater plasticity of cognitive functions in carriers of the Val/Val genotype and may be used for prediction and development of methods for differentiated correction of age-related cognitive decline.

Attention Control Measures Improve the Prediction of Performance in Navy Trainees

ABSTRACTMilitary selection tests leave room for improvement when predicting work‐relevant outcomes. We tested whether measures of attention control, working memory capacity, and fluid intelligence improved the prediction of training success above and beyond composite scores used by the U.S. Military. For student air traffic controllers, commonality analyses revealed that attention control explained 9.1% (R = .30) of the unique variance in academic performance, whereas the Armed Forces Qualification Test explained 5.2% (r = .23) of the unique variance. For student naval aviators, incremental validity estimates were small and nonsignificant. For student naval flight officers, commonality analyses revealed that attention control measures explained 11.8% (R = .34) of the unique variance in aviation preflight indoctrination training performance and 4.3% (R = .21) of the unique variance in flight performance. Although these point estimates are based on relatively small samples, they provide preliminary evidence that attention control measures might improve training outcome classification accuracy in real‐world samples of military personnel.

Analyzing critical success factors in Lean Six Sigma training

PurposeThis study aims to assess the effectiveness of Lean Six Sigma (LSS) training by investigating critical success factors (CSFs) categorized into the domains of people, processes and technology.Design/methodology/approachA survey methodology, information was used to collect information from a participant pool of 102 individuals. The collected data were analyzed using ANOVA to examine the relationship between CSF and LSS training.FindingsOrganizing CSF significantly enhances the effectiveness of LSS training. High ratings were consistently observed for experienced instructors, structured materials and interactive elements. However, challenges were identified in evaluating the impact of training and the integration of e-learning platforms. These findings shed light on areas where improvements can be made to further enhance the outcomes of LSS training programs.Research limitations/implicationsThe sample size of 102 participants may limit the generalizability of the findings to a broader population. This study primarily examined short-term outcomes, so additional exploration of the long-term effects of LSS training is warranted. This research acknowledges potential bias in self-reported survey data and recognizes that personal perspectives may influence participant responses.Originality/valueThis research contributes a nuanced perspective by categorizing CSFs into the domains of people, process and technology, offering a comprehensive understanding of their interplay. Acknowledging the challenges in training evaluation and e-learning platforms adds originality to the study and provides practical insights for organizations aiming to optimize their LSS training initiatives.

The path ahead for integrative public leadership: a systematic review and call for future research

PurposeThe study aims to review integrative public leadership (IPL) scholarship, identify trends and suggest future research. The paper answers the question, “How has the field of study of integrative public leadership developed, and what gaps should future research address?”Design/methodology/approachA systematic literature review (SLR), utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 protocol, was conducted over the period 2000–2023. The preliminary database returned 497 articles; however, 55 articles remained after the screening phase. Three themes were addressed: the conceptualization of IPL (what it is), the study characteristics (how and where it was completed) and what has been studied (what we know about IPL).FindingsIPL differs from its related concepts: “shared” and “distributed leadership.” Cross-boundary behaviors are one of IPL’s pillars. Most studies focus on the local level and center on upper-echelon leaders. IPL has been linked to leadership training and positive outcomes, such as organizational and network performance.Research limitations/implicationsThis review focused on articles in refereed journals, excluding books.Practical implicationsThis work provides a twofold contribution in that it: (1) sharpens the concept of integrative public leadership, establishing the boundaries with similar concepts and (2) provides an overview of the field, identifying relevant areas for future research.Originality/valueThis work provides a twofold contribution in that it: (1) sharpens the concept of integrative leadership, establishing the boundaries with similar concepts and (2) provides an overview of the field, identifying relevant areas for future research.

Multi-session adaptation to audiovisual and sensorimotor biofeedback is heterogeneous among adolescents with cerebral palsy.

There is growing interest in the use of biofeedback-augmented gait training in cerebral palsy (CP). Audiovisual, sensorimotor, and immersive biofeedback paradigms are commonly used to elicit short-term gait improvements; however, outcomes remain variable. Because biofeedback training requires that individuals have the capacity to both adapt their gait in response to feedback and retain improvements across sessions, changes in either capacity may affect outcomes. Yet, neither has been explored extensively in CP. In this study, we evaluated the extent to which adolescents with CP (7M/1F; 14 years (12.5,15.26)) could adapt gait and retain improvements across four, 20-minute sessions using combined audiovisual and sensorimotor biofeedback. Both systems were designed to target plantarflexor activity. Audiovisual biofeedback displayed real-time soleus activity and sensorimotor biofeedback was provided using a bilateral resistive ankle exoskeleton. We quantified the time-course of change in muscle activity within and across sessions and overground walking function before and after the four sessions. All individuals were able to significantly increase soleus activity from baseline using multimodal biofeedback (p < 0.031) but demonstrated heterogeneous adaptation strategies. In-session soleus adaptation had a moderate positive correlation with short-term retention of the adapted gait patterns (0.40 ≤ ρ ≤ 0.81), but generally weak correlations with baseline walking function (GMFCS Level) and motor control complexity (ρ ≤ 0.43). The latter indicates that adaptation capacity may be a critical and unique metric underlying response to biofeedback. Notably, in-session gains did not correspond to significant improvements in overground walking function (p > 0.11). This work suggests that individuals with CP have the capacity to adapt their gait using biofeedback, but responses are highly variable. Characterizing the factors driving adaptation to biofeedback may be a promising avenue to understand the heterogeneity of existing biofeedback training outcomes and inform future system optimization for integration into clinical care.

Sensing equivalent kinematics enables robot-assisted mirror rehabilitation training via a broaden learning system.

Robot-assisted mirror therapy has been widely developed to help remodeling of premotor cortex for patients suffering from motor disability of limbs. Nevertheless, it is difficult to achieve real-time adaptive control in robot-assisted mirror rehabilitation training, particularly for patients with varying levels of limb impairment. This paper proposes an equivalent kinematics control framework based on the Broaden Learning System model for active robotic mirror rehabilitation, where people's bilateral upper limbs actively perform mirror movements to enhance the impaired limb's participation. The framework accommodates a broaden learning model from sensing multi-kinematic features to adjust the robotic damping coefficient in assisting human participants to complete mirror-symmetry training. Besides, in order to adapt to inter-patients' variability with different disability levels, a challenge-level modification interface is also fused for safer training. This model is verified by additional symmetry indicator such as position trajectory error and force. Experimental results show that the weaker subjects can also maintain mirror movement with the stronger subjects under the help of this model and verify the performance of framework in mirror-symmetry effects and movement smoothness. This leads us to believe that the framework can safely and efficiently assist human participants in completing mirror-symmetry movement. The framework has the potential to improve outcomes in smoother and safer mirror-symmetry training by sensing multi-kinematic features. Future studies are necessary to involve clinical trials with actual patients.

Controlling Virtual Reality With Brain Signals: State of the Art of Using VR-Based Feedback in Neurofeedback Applications.

The rapid progress of commercial virtual reality (VR) technology, open access to VR development software as well as open-source instructions for creating brain-VR interfaces have increased the number of VR-based neurofeedback (NF) training studies. Controlling a VR environment with brain signals has potential advantages for NF applications. More entertaining, multimodal and adaptive virtual feedback modalities might positively affect subjective user experience and could consequently enhance NF training performance and outcome. Nevertheless, there are certain pitfalls and contraindications that make VR-based NF not suitable for everyone. In the present review, we summarize applications of VR-based NF and discuss positive effects of VR-based NF training as well as contraindications such as cybersickness in VR or age- and sex-related differences. The existing literature implies that VR-based feedback is a promising tool for the improvement of NF training performance. Users generally rate VR-based feedback more positively than traditional 2D feedback, albeit to draw meaningful conclusions and to rule out adverse effects of VR, more research on this topic is necessary. The pace in the development of brain-VR synchronization furthermore necessitates ethical considerations on these technologies.

A systematic review of mental health stigma reduction trainings for law enforcement officers.

The aim of the present systematic review was to evaluate the outcome of law enforcement officer (LEO) trainings on mental health (MH) stigma and other outcomes. A systematic search of Pubmed, APA PsycInfo, and Cochrane Central Register of Controlled Trials was conducted to identify studies examining MH stigma trainings implemented within the LEO profession. Both randomized and nonrandomized studies were considered. Risk of bias was assessed via the Cochrane Risk-of-Bias tool for randomized trials and the Risk of Bias in Non-Randomized Study of Intervention (Version 2). The present review identified 18 studies comprised of 2,399 participants (Mage = 37.37, SD = 4.76). Samples were predominantly composed of police officers (k = 16), followed by correctional officers (k = 2) and both (k = 1). Although the review aimed to investigate trainings targeting institutional, public, and self-stigma, all studies implemented trainings intended to decrease public stigma. Outcomes evaluated across studies included attitudes toward MH, knowledge about MH, self-efficacy/confidence, behavioral responses/de-escalation skills, social distance, and awareness, support, and utilization of MH resources. Although the outcomes evaluated were somewhat consistent across studies, there was variability in how variables were defined and measured. Due to this, data could not be compared across studies, and thus, conclusions could not be drawn regarding which trainings demonstrated the most effectiveness in reducing MH. Despite the increased research investigating the outcomes of trainings on stigma within the LEO population, the variability in methodology and the high rate of bias exhibited across studies suggest that more rigorous and better quality evaluations are warranted. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Nurses' models of spiritual care: Predictors of spiritual care competence.

Previous studies have shown that nurses' spiritual care competence is related to characteristics of personal spirituality, training adequacy, and comfort, confidence, and frequency of provision of spiritual care. However, these studies assumed that all participants understood spiritual care in the same way, and used self-ratings of spiritual care competence, which are problematic. Our previous study found that spiritual care was understood in 4 qualitatively different ways that can be arranged in order of competence. This study aimed to re-examine the relationships between nurse characteristics and spiritual care competence, using spiritual care understanding as a proxy for competence. Data was collected from a convenience sample of nurses who completed an anonymous, online survey. The survey provided qualitative data about what spiritual care means for them. The survey also provided quantitative data regarding nurse characteristics. This study created sub-groups of nurses based on their understanding of spiritual care, and used the quantitative data to construct a profile of nurse characteristics for each sub-group. Kruskal-Wallis statistical tests determined whether nurse characteristics differed across the 4 sub-groups. Spiritual care competence was not related to confidence or comfort in providing spiritual care. Relationships with spirituality, training adequacy, and frequency of provision of spiritual care were not linear; i.e., higher competence did not always correspond with higher scores of these characteristics. The results raise concerns about the construct validity of using comfort and confidence as estimates of spiritual care competence. That the relationships between competence and spirituality, training adequacy, and frequency of spiritual care provision was not as linear as portrayed in extant literature, suggests that outcomes of training may depend on the type of spiritual care understanding subscribed to by training participants. The findings offer insights about how nurses could achieve high levels of spiritual care performance.

Effects of cryo-facial mask on running performance in amateur middle-distance runners

The excess heat accumulated during exercise can lead to stress-induced fatigue, possibly impairing athletic performance. Various precooling techniques have been applied to enhance thermal comfort, reduce perception of effort, and improve endurance. In this randomized crossover study, twelve male amateur middle-distance runners (age: 33.69 ± 5.9 years; body mass: 71.9 ± 4.4 kg; height: 178.4 ± 5.6 cm; V˙O2 peak: 63.3 ± 5.6 mL min−1·kg−1) wore a facial cooling mask before a time-to-exhaustion (TTE) test on a treadmill, under cryostimulation or control conditions. The running performance comprised also two constant load trials, one conducted before and another after wearing the mask, both performed at the velocity of the first ventilatory threshold. Under cryostimulation condition, the TTE was 13 % higher than the control condition (p = 0.0049; d = −0.19) with a significant main effect of time for both ratings of perceived exertion (F1, 22 = 50.10; p < 0.0001; η2p = 0.69) and heart rate (F1, 22 = 31.53; p < 0.0001; η2p = 0.59). A significant interaction “condition × time” was found for facial skin temperature (F2, 44 = 36.93; p < 0.0001; η2p = 0.63) and for heart rate during the constant load trial after wearing the mask (F1, 22 = 5.90; p = 0.0238; η2p = 0.21). The localized cryostimulation provided by the mask lowered the skin temperature on the face, potentially mitigating the negative effects of heat stress during running. Incorporating the cryo-facial mask as part of a pre-exercise routine for runners may offer a practical and convenient method to optimize performance and enhance overall training outcomes.

Augmented reality for basic skills training in laparoscopic surgery: a systematic review and meta-analysis.

Augmented reality (AR) has emerged as a transformative technology in medical education, particularly in training basic laparoscopic skills. Despite its growing applications, the effectiveness of AR in this specific domain remains underexplored, with a lack of standardized assessment frameworks and inconsistent methodologies across studies. This systematic review and meta-analysis aimed to evaluate the effectiveness of AR in laparoscopic basic skills training for medical students and junior physicians. We conducted a systematic review and meta-analysis following PRISMA guidelines. Databases searched included PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov. Studies were selected based on their focus on AR applications in laparoscopic training, involving both randomized controlled trials and non-randomized studies. Inclusion criteria focused on medical students and novice surgeons, assessing educational outcomes such as Global Operative Assessment of Laparoscopic Skills (GOALS) Global, Objective Structured Assessment of Technical Skills (OSATS) Global, OSATS Specific, Training Time, and Subjective Workload. A total of 12 studies involving 434 participants met the inclusion criteria. The analysis revealed that AR technology significantly improved educational outcomes, with participants achieving higher GOALS and OSATS scores. Specifically, the mean difference for GOALS scores was 2.40 points (95% CI [1.30, 3.50], p < 0.001) and for OSATS scores, 7.71 points (95% CI [3.39, 12.03], p < 0.001). Additionally, AR-assisted training showed a reduction in subjective workload, with a mean decrease of 2.95 points (95% CI [- 4.95, - 0.95], p = 0.003). The findings indicate that AR significantly enhances laparoscopic training outcomes, facilitating improved technical skills, efficiency, and learner independence. However, variability in study designs and outcomes limits generalizability. Future research should focus on standardize AR training protocols and evaluate long-term effectiveness to fully leverage AR's potential in surgical education.

Synergy Analysis of Pedagogical Competence and Managerial Competence in Fish Preservation Industry Management Training in Maluku Province

This study aims to obtain and analyze data regarding: 1) The effect of pedagogical competence on learning outcomes of fish preservation industry management training in Maluku Province. 2) The effect of managerial competence on learning outcomes of fish preservation industry management training in Maluku Province. 3) The effect of a synergy of pedagogical competence and managerial competence in the process of industrial management training for fish preservation in Maluku Province. With a population of 40 people and a sample of 15 employees. The instrument used to collect data in this study is a questionnaire. This study uses multiple regression analysis. The data were then subjected to descriptive analysis, classical assumption testing, and hypothesis testing. The results showed that: 1) There is an influence of pedagogical competence on learning outcomes of fish preservation industry management training in Maluku Province, meaning H1 is accepted. 2) There is an influence of managerial competence on learning outcomes of fish preservation industry management training in Maluku Province, meaning H2 is accepted. 3) There is an influence of the synergy of pedagogical competence and managerial competence in the process of fish preservation industry management training in Maluku Province, meaning H3 is accepted. Keywords: pedagogical competence, managerial competence, training. Keywords: pedagogical competence, managerial competence, training

A single-blind, randomised control trial on the effectiveness of a structured multi component training module for family caregiver of persons with Parkinson's disease: A study protocol.

Parkinson disease (PD), a neurodegenerative disorder that progresses over time, is steadily growing in number and prevalence worldwide. PD in Malaysia is expected to increase five-fold by 2040 from the existing estimate of 20,000 patients in 2018. Treatment program of PD in Malaysia is rather unstructured, and there is no known comprehensive PD family caregiver training program available to date. To ensure the quality of a program, it must be tested for feasibility, effectiveness and sustainability. This paper describes the protocol of a study that evaluates the effectiveness of a structured, comprehensive training program of family caregiver to persons with PD in comparison to usual care. A total of 60 pairs of persons with PD of stage II and III, and their primary family caregiver will be recruited and allocated into either an experimental or a control group for 12 weeks of intervention. The experimental group will undergo initial training from multi-disciplinary healthcare providers and will be given a physical module containing weekly tasks that must be practised at home. While the control group will receive a usual care. Both groups will be assessed in terms of physical functions, functional mobility, quality of life (QoL), caregiver burden and knowledge using standardised assessment tools namely Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Timed Up and Go (TUG) test, Parkinson's Disease Questionnaire (PDQ-39), European Quality of Life five-dimensions (EQ-5D), Malay version of Zarit Burden Interview (MZBI) and Knowledge of Parkinson Disease Questionnaire (KPDQ). In addition, the feasibility and sustainability of the interventions will be evaluated, alongside its cost-effectiveness based on the average and incremental cost effectiveness ratio. All data will be analysed using descriptive and inferential statistics, particularly mixed model ANOVA. There is a significant gap in the literature pertaining family caregiver training programs for people with PD. Documented programs are lacking in term of comprehensiveness of content, application approach and the measurement of training outcomes including the program cost-effectiveness. The feasibility and effectiveness of such training program in a Malaysian setting also requires investigation due to differences in living environment, support system and population's perception. This study will assist to fulfil the existing literature gap and demonstrate the potential benefit of caregiver involvement in mediating the care and therapy for PD in the home setting. Optimum knowledge and skills gained through the training are expected to enhance the confidence and ability of the family caregivers and may possibly reduce their perceived caregiving burden. The protocol of this study is registered in the Australian-New Zealand Clinical Trial Registry (ANZCTR) with a registration number ACTRN12623000336684.